| Entity Name: | JAX PSYCHIATRY LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 20 Mar 2017 (8 years ago) |
| Document Number: | L17000062752 |
| FEI/EIN Number | 82-0998985 |
| Address: | 98 Lumen Ct, ST Augustine, FL, 32095, US |
| Mail Address: | 98 Lumen Ct, St Augustine, FL, 32095, US |
| ZIP code: | 32095 |
| County: | St. Johns |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1124538525 | 2017-10-11 | 2021-10-12 | 145 HILDEN RD STE 108, PONTE VEDRA, FL, 320818401, US | 145 HILDEN RD STE 108, PONTE VEDRA, FL, 320818401, US | |||||||||||||
|
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| Phone | +1 904-834-1242 |
Authorized person
| Name | RIAZ AHMED |
| Role | M.D./ PRESIDENT |
| Phone | 9048348042 |
Taxonomy
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| AHMED RIAZ | Agent | 98 Lumen Ct, St Augustine, FL, 32095 |
| Name | Role | Address |
|---|---|---|
| AHMED RIAZ | President | 98 Lumen Ct, St Augustine, FL, 32095 |
| Name | Role | Address |
|---|---|---|
| AHMED MUNAZZA | Vice President | 98 Lumen Ct, St Augustine, FL, 32095 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-04-10 | 98 Lumen Ct, ST Augustine, FL 32095 | No data |
| CHANGE OF MAILING ADDRESS | 2020-03-13 | 98 Lumen Ct, ST Augustine, FL 32095 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-03-13 | 98 Lumen Ct, St Augustine, FL 32095 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-14 |
| ANNUAL REPORT | 2023-02-20 |
| ANNUAL REPORT | 2022-04-10 |
| ANNUAL REPORT | 2021-02-28 |
| ANNUAL REPORT | 2020-03-13 |
| ANNUAL REPORT | 2019-02-17 |
| ANNUAL REPORT | 2018-04-08 |
| Florida Limited Liability | 2017-03-20 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
